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Nothing to Sneeze At! SLE and Allergies in Offspring

February 19 2016 1:49 PM ET via RheumReports RheumReports

A small number of observational studies have hinted at a possible connection between women with SLE and an increased risk of allergic conditions (e.g. asthma, allergic rhinitis, urticaria, etc) in their offspring. In an attempt to categorize this further, Dr. Julie Couture and colleagues from McGill University undertook a large, population based study to determine if children of mothers with SLE have an increased risk of allergic conditions compared to a control population of children born to mothers without SLE (Abstract 032).

The group used data from the "Offspring of SLE Mothers Registry" (OSLER) which includes all women with SLE, identified through Quebec's universal healthcare databases, who had been hospitalized for delivery one or more times between 1989 and 2009. A control cohort consisting of women randomly chosen and matched 4:1 for age and year of delivery, who did not have a diagnosis of SLE prior to or at the time of delivery, was also analyzed. Allergic conditions in children born to these mothers were identified according to ≥ 1 hospitalization or ≥ 1 physician visit with a relevant diagnostic code; these diagnoses included asthma, allergic rhinitis, eczema, cutaneous allergy, urticaria, angioedema, and anaphylaxis. Multivariate analysis was performed to adjust for maternal age, education, race/ethnicity, calendar year of birth and sex of child, and obstetrical complications. Further adjustment was also done for use of antimalarials and immunosuppressive drugs.

509 women with SLE who had 719 children were analyzed, compared to a control population of 5824 women with 8493 children. Interestingly, children of mothers with SLE had slightly more allergic conditions compared to children in the control population (66.1% vs 59.3%, respectively). The most frequently observed conditions in the SLE children were eczema and asthma. In the multivariate analysis, children born to mothers with SLE had an increased risk of allergic conditions (OR 1.36; 95% CI 1.41, 1.61).

So what might account for this increased risk? The reasons are likely multifactorial, including genetics, cytokines, maternal autoantibodies as well as in utero exposure. The relationship is certainly interesting and seems to substantiate, on a larger scale, findings found in prior case reports.


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About the Author

Dr. Pari Basharat
Dr. Pari Basharat

Dr. Pari Basharat, BSc, MD is a Rheumatologist based in London, ON.

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